Ryan White HIV/AIDS Program
The Ryan White Program is a federal program designed specifically for the care and treatment and support programs for people with HIV/AIDS in the United States.
The Ryan White Program is administered by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (DHHS).
The program was first enacted in 1990. The program has been reauthorized by Congress four times since first created (in 1996, 2000, 2006, and 2009).
The Ryan White Program is a “payer of last resort” program that exists to provide coverage, care, and treatment, for those who have no other source of coverage or face coverage limits.
Funding for the Ryan White program is subject to Congressional appropriations each year. It is the third largest source of federal funding for HIV care in the U.S., after Medicare and Medicaid reaches more than half a million people with HIV each year. In addition to federal funding, some states and localities also provide funding to their Ryan White services (including through certain state matching funds requirements).
Part C of the Ryan White Program funds medical providers who deliver comprehensive medical care and treatment to people with HIV who have no other source for care.
Another vitally important program for HIV patients is the AIDS Drug Assistance Program (ADAP), which is funded through Part B of the Ryan White Program.
The Affordable Care Act (ACA) law passed in 2010, had significant implications for the Ryan White Program. Starting in 2014 many of Ryan White patients who received care and treatment through the Ryan White program received new coverage through other programs created under the ACA – either Medicaid expansion or insurance purchased through the State Insurance Exchanges.
Because Ryan White is a “payer of last resort” program, those patients who have access to other forms of coverage must use them first. However, the Ryan White program is able to assist patients with insufficient benefits, inadequate access to medications, and less than adequate access to care.
In 2017, Congress spent nine months hotly debating bills introduced to repeal and replace the Affordable Care Act with the American Health Care Act (strongly supported by the Trump administration). Those efforts were unsuccessful and discontinued in September, 2017.
In February 2018, the President’s proposed a FY 2019 budget would have reduced funding for the Ryan White CARE Act by $47 million, primarily by de-funding the program’s AIDS Education and Training Centers and Special Programs of National Significance. The FY 2019 budget, passed by Congress in March 2018, reversed these cuts and retained funding for both programs.